The nation's transplant network has voted unanimously in favor of changing
that system in favor of one that ranks patients on the basis of need.

The new system will be based on formulas--one for children and another
for adults--that use laboratory tests to calculate patients' short-term
risk of dying without a transplant.

Under the current system, patients already are categorized into urgency
groups. But the present system uses the amount of time patients spent
on the waiting list as a tiebreaker.

The revised system would replace all but one of the four existing categories
with a continuous score, giving those with the highest score first crack
at a transplant no matter how long they have been on the waiting list.
The top category meant for those in the most critical condition will remain
as the only firm category in place.

The change comes at a time when the transplant network has faced growing
criticism for failing to distribute organs to the neediest patients.

Much of that criticism has focused on the network's refusal to distribute
donated livers across geographic borders. Critics have said this system
allows patients in one city to die, while a healthier patient in another
area receives a transplant.

The new system will not address those concerns. Scores will be compared
within the preset geographic borders.

Still, representatives of the United Network for Organ Sharing (UNOS)
said they believe the changes would create a fairer system.

UNOS is the non-profit organization that maintains the national Organ
Procurement and Transplantation Network under a contract with the Department
of Health and Human Services.

"We believe this new system is objective, it will save lives on
the waiting list, and it allows for additional enhancements," said
UNOS President Dr. Jeremiah G. Turcotte in a statement.

UNOS added that the new system would take effect in 2002, pending approval
from HHS and a transition period aimed at allowing patients who have spent
a long time on the waiting list to have a chance at receiving a donated
organ.

The vote was taken on Thursday at the organization's mid-year meeting
in Alexandria, Virginia.

UNOS also voted to ease its rules on infant heart transplants. Under
the new policy, UNOS will now permit babies younger than 1 year old to
receive heart transplants that don't match their blood type.

This change followed the widely reported case of a 6-week-old girl in
Denver, Colorado, who died in September while awaiting a heart.

Calls to UNOS seeking further details and comment were not returned at
press time.